Tonsillitis vs. Strep: What’s the Difference?

Tonsil stones and strep throat are two different conditions. Sometimes, due to a lack of knowledge, people are not able to identify or distinguish between them. Tonsil stones appear like crusts in tonsils, in strep throat you develop swelling in the tonsils. 

Tonsil stones, also called tonsilloliths, is a condition in which white or yellow stone-like structures form on the tonsils (1). On the other hand, in strep throat, large, tender lymph nodes develop in the neck. 

Let’s learn a little more about them and compare tonsil stones vs. strep throat for better understanding. 

Difference Between Strep Throat and Tonsil Stones

Strep Throat

Strep throat is a bacterial infection that occurs due to Streptococcus bacteria (2). It is a type of tonsilitis in which the infected person develops a sore throat.

Below are the major symptoms of strep throat-

• Large and tender lymph nodes in the neck
• Red spots on the epiglottis (roof of mouth)
• Difficulty on swallowing 
• Pain and body aches
• Fever 

Since it is caused by bacteria, the doctor prescribes oral antibiotics to correct it. When taken in time, antibiotics help reduce the severity of the condition and prevent it from spreading and infecting others.  

Tonsil Stones

Tonsil stones occur when the crevices and pits on tonsils, called tonsil crypts, trap debris and dead cells along with virus, bacteria and fungi (3). Over time, calcium starts building up around the trapped substances, leading to the formation of tonsil stones. 

They appear white or yellow around the tonsils and are usually easy to identify. Even though tonsil stones or tonsilloliths are not dangerous, they can cause bad breath and sore throat. 

When tonsil stones are small, they stay asymptomatic; however, once they start growing, you may experience the following symptoms-

• Sore throat and difficulty in swallowing 
• Bad breath and swollen tonsils 
• Pain in ear 
• Cough 

If the tonsil stones are large, they are easy to notice as they appear as white or yellow crusts on the tonsils. 

Below is the table differentiating tonsil stones and strep based on different factors-

Feature	Tonsil Stones	Strep Throat
Definition	Small, hard, calcified masses formed in the crevices of the tonsils due to debris and bacteria buildup	Bacterial infection caused by Streptococcus bacteria affecting the throat and tonsils
Symptoms	Persistent bad breath Sore throat Difficulty swallowing Ear pain or discomfort	Sore throat Difficulty swallowing Fever Swollen, tender lymph nodes in the neck
Appearance	Small, white or yellowish, irregularly-shaped formations visible on or within the tonsils	Redness and swelling of the throat and tonsils; may have white patches or pus on the tonsils
Cause	Accumulation of food particles, bacteria, dead cells, and mucus in the tonsil crevices	Infection with Streptococcus bacteria, typically Streptococcus pyogenes (group A streptococcus)
Treatment	Gentle removal at home using a cotton swab or oral irrigation Gargling with salt water Antibiotics if severe	Antibiotics (usually penicillin or amoxicillin) Over-the-counter pain relievers Rest and fluids
Complications	Rare but can cause persistent discomfort, halitosis, and in severe cases, difficulty swallowing	If left untreated, complications may include rheumatic fever, kidney inflammation, or scarlet fever

While strep throat is caused by bacteria, Streptococcus, and tonsil stones are the result of debris accumulation and calcium deposition around them in the tonsil crypts. 

You may get a fever in strep throat but never in tonsil stones. The stones will only cause irritation and difficulty in swallowing (4). At the same time, foul odor is also its telltale sign which is not experienced in strep throat. 

Complications of Tonsil Stones and Strep

Usually, both these conditions do not cause any serious problems. However, when strep throat is left untreated, it may cause complications such as-

• Inflammation of kidney 
• Scarlet fever
• Rheumatic fever 

On the other hand, though rarely, people may experience the following complications with tonsil stones-

• Halitosis (extremely bad breath)
• Tooth decay 
• Damage to tonsil tissue 

Preventions of Tonsil Stones and Strep

Since strep throat occurs due to bacteria, maintaining good hygiene can help prevent the condition. Some people are prone to getting strep throat. They should frequently wash their hands with soap and water, especially before eating. 

People who develop tonsil stones tend to get them often. Below are some of the preventive steps that can help avoid the condition-

• Good oral hygiene 
• Gargling with salt water 
• Staying hydrated 
• Quitting smoking

Conclusion 

Strep throat and tonsil stones are two different conditions with a few overlapping symptoms, such as inflammation and difficulty in swallowing. 

Here, it is important to mention that strep throat is a contagious disease and can easily spread when an infected person comes in direct contact. Therefore, maintaining a distance with your loved ones is essential to keep them away from strep throat.

On the other hand, tonsil stone is not a contagious problem. it will happen only if there are pits in tonsil crypts and they have the tendency to trap debris too. Once a person starts developing tonsil stones, it is highly likely that they will get it again. 

Preventive measures can keep both problems at bay. 

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